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General NPI Number Information
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NPI Number | 1245589019
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Entity Type | Individual
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Provider Name | KRUTI RUCHIK MEHTA PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 07/13/2013
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Provider Practice Location Address
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Address Line | 2501 W ROOSEVELT BLVD
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City | MONROE
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State | NC
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Zip | 28110-0418
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Country | US
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Telephone | 704-283-1506
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Fax |
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Provider Business Mailing Address
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Address Line | 1543 HEATHER GLEN RD
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City | KANNAPOLIS
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State | NC
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Zip | 28081-6410
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Country | US
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Telephone | 843-597-4261
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23030
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License Number State | NC
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